Psychosocial Factors Surrounding Aesthetic Rhinoplasty: A Systematic Review.

[BACKGROUND] Rhinoplasty, widely known to improve form and function, is growing in popularity for both cosmetic and functional purposes. The preexisting psychosocial state of a patient significantly affects the perceived outcome of aesthetic rhinoplasty, even when surgery is technically successful. Given the elevated rates of distress, depression, social dysfunction, and body dysmorphic disorder among candidates, psychosocial optimization is essential.

[METHODS] A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published from January 2000 to August 2024 examining associations between aesthetic rhinoplasty outcomes and psychological factors were identified through PubMed, Cochrane Library, and Embase. Eligible studies evaluated psychosocial characteristics, preoperative mental health status, and postoperative satisfaction.

[RESULTS] Patients with preexisting mental health conditions, including body dysmorphic disorder, anxiety, and depression, consistently reported lower postoperative satisfaction despite technically successful results. Patient-reported outcome measures demonstrated that psychological readiness, social context, and expectation setting significantly influenced perceived outcomes. Individuals with diminished psychosocial functioning were more likely to experience reduced postoperative satisfaction, underscoring the interplay between psychological pathology and subjective assessment of surgical success.

[CONCLUSIONS] Evaluating patient motivations, expectations, and psychosocial readiness allows physicians to better predict satisfaction and improve expectation management. Incorporating a thorough preoperative mental health assessment can help identify modifiable psychosocial factors and optimize outcomes for patients pursuing aesthetic rhinoplasty.